Among various wounds, no matter in the clinical treatment of various injuries such as burn injury, cold injury, crush injury, war injury, animal bite, nuclear radiation injury and combined injury, or in the open or closed wound, the prevention of infections, the promotion of tissue repair and the wound healing are always an everlasting subject matter in the treatment of wound.
Bacterial infections are cute systemic infections or local infections caused by pathogenic bacteria or opportunistic pathogenic bacteria invading the blood circulation or local environment for growth and propagation therein and producing toxins or other metabolites, which is clinically characterized by chills, hyperpyrexia, erythra, joint pain and hepatosplenomegaly, partly with infectious shock and migrated lesions. Especially in elders, children, persons with a chronic disease or immunodeficiency, or in persons with complications due to delayed treatment, the condition may develop to septicemia or septicopyemia.
There are various kinds of pathogenic bacteria or opportunistic pathogenic bacteria capable of infecting human, which can invade the tissues and organs in different sites in human, causing local or systemic inflammatory responses and various diseases.
In nonspecific infections (i.e., the pyogenic infections), common ones are furuncle, carbuncle, erysipelas, acute lymphangitis, acute lymphadenitis, paronychia, felon, lateral pyogenic tenosynovitis of fingers, bursitis, palm deep space infection, pyemia, bacteremia and others, caused by pathogenic bacteria such as Staphylococcus aureus, Streptococcus hemolyticus, Escherichia coli, Pseudomonas aeruginosa and the like. The infection may be caused by a single bacterium, or the infection may be a combined infection caused by several bacteria, and thus, it is important to have a broad spectrum for a clinic medicament.
Acne is also a nonspecific infection commonly and frequently occurred in adolescents, which sometimes occurs in middle-aged people. Clinical manifestations thereof include whitehead acne, blackhead acne, inflammatory papule, secondary abscess, hydatoncus or nodule, paining and itching. If infection happens, there may leave scars, influencing the appearance as well as physical and psychological health. Now, it is known that there are many pathogenic factors and segments playing a key role in the onset, progression and turnover of acne, among which the most important reason is microbial action in hair follicle and pilosebaceous units, wherein the first cause is anaerobic Propionibacterium acnes, and the second cause is aerobic Staphylococcus epidermidis and Staphylococcus aureu. Bacterial infection is an important pathogenic factor in the onset of acne.
A specific infection refers to tuberculosis, tetanus, gas gangrene, anthrax, pertussis, epidemic encephalomyelitis, gonorrhea, typhia, bacillary dysentery, diphtheria, each of which is an disease specifically caused by Mycobacterium tuberculosis, Clostridium tetani, Clostridium perfringens, Bacillus anthraci, Bordetella pertussis, Neisseria meningitides, Neisseria gonorrhoeae, Salmonella typhi, Shigella, Corynebacterium diphtheria, respectively. A specific infection is different from a general infection in terms of pathogenic bacteria, disease progression and treatment, etc., which are the main subjects in epidemiological studies.
Promotion of wound healing is one of the two problems in traumatology, which is equally as important as anti-infection. Recently, with the intervention of modern cell biology and molecular biology studies, cell activities and influence factors thereof during would healing have been observed in a large number of experiments, and it was considered that various growth factors were involved in the regulation of the wound healing process, with the possible mechanisms being very complex.
A chronic refractory infection wound surface is a general term for wound surfaces infected with bacteria in a chronic refractory wound on the body surface. The chronic refractory wound surface on the body surface is caused by a series of wounds and diseases. The wound surfaces which are developed on the body surface and do not heal for a long time mainly include traumatic ulcers, lower extremity venous ulcers, pressure ulcers and diabetic ulcers. Due to features such as development on the body surface, long course of disease, large influences on appearance, high incidence of complications and extremely high treatment expenses, there will be large influences on lives and qualities of patients, which is an important issue that modern society must face.
Among the chronic refractory wound surfaces on the body surface, 87% suffer from bacterial infections, mainly with Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. Due to the long treatment course, a large majority of the bacteria on the wound surface would develop drug resistance in varying degrees; particularly when the refractory wound surface is infected with MRSA, MRCNS, erythromycin-resistant Streptococcus pyogenes, ESBL-producing Escherichia coli, imipenem-resistant Pseudomonas aeruginosa strains (IPM-R strains). Due to the lack of clinically effective medicaments for treatment, the serious consequences of amputation may happen.
Eczema is a skin inflammatory response having polymorphic skin damages and tendency of exudation, which is caused by various endogenous and exogenous factors, the etiology is unresolved and is believed to be multifactorial The subjective symptom is fierce pruritus. Recurrence risk is high and is accompanied by secondary bacterial infections, which cannot be cured for many years.
Regarding prevention of wound infections, a common drug is antibiotics; however, drug resistance of a pathogenic bacterium caused by antibiotics abuse has made no drug available for many wounds, resulting in systemic infections in patients: pyemia, bacteremia, serious injuries in other organs, or chronic refractory wound surfaces forming on the body surface. The drug resistance issue of antibiotics has become a global focus. Another hazard of the drug-resistance bacteria is that they can spread among populations between different regions or counties. Streptococcus pneumonia is a common etiological bacterium causing bacterial pneumonia. Recently, the drug resistance thereof to antibiotics has been on the rise, and there have been multi-drug resistant strains developed, which has become a troublesome problem in clinical infection control. Currently, many anti-bacterial infection drugs, mostly, have poor efficacy due to infections with drug-resistant bacteria, in particular methicillin-resistant Staphylococcus aureus (MRSA). Therefore, there is an urgent need to develop a new antiseptic substance.
Recently, studies on bioactive antiseptic peptides have become frontier science in antibiotics development in international pharmacies. There have been over 1300 antiseptic peptides successfully separated and identified currently, which were commonly characterized by a small molecular weight (12-100 amino acid residues), cationic polymer and amphiphilic construction. These bioactive substances referred to as peptide antibiotics, due to features such as pure living organism, strong stability and antiseptic ability, broad spectrum, no drug resistance, no toxic side effect and “three-induced” action, have been considered as optimal alternatives to the existing antibiotics. An active antiseptic active Ctryamp polypeptide or structurally homologous polypeptides thereof are naturally occurring antiseptic peptides molecules obtained from Chaerilus tryznai Kovarik. They can rapidly kill microorganisms (including drug-resistant bacteria produced by using traditional antibiotics) without producing drug resistance by itself, with different production mechanism, bactericidal mechanism and mode of action from traditional antibiotics, and from which the hydrolyzed amino acids may facilitate the generation of skin tissues.